title: Seroepidemiologic survey of epidemic cholera in Haiti to assess spectrum of illness and risk factors for severe disease.
abstract: To assess the spectrum of illness from toxigenic Vibrio cholerae O1 and risk factors for severe cholera in Haiti, we conducted a cross-sectional survey in a rural commune with more than 21,000 residents. During March 22-April 6, 2011, we interviewed 2,622 residents ≥ 2 years of age and tested serum specimens from 2,527 (96%) participants for vibriocidal and antibodies against cholera toxin; 18% of participants reported a cholera diagnosis, 39% had vibriocidal titers ≥ 320, and 64% had vibriocidal titers ≥ 80, suggesting widespread infection. Among seropositive participants (vibriocidal titers ≥ 320), 74.5% reported no diarrhea and 9.0% had severe cholera (reported receiving intravenous fluids and overnight hospitalization). This high burden of severe cholera is likely explained by the lack of pre-existing immunity in this population, although the virulence of the atypical El Tor strain causing the epidemic and other factors might also play a role.
authors.forename: Brendan R
authors.initials: BR
authors.lastname: Jackson
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Talkington
authors.forename: James M
authors.initials: JM
authors.lastname: Pruckler
authors.forename: M D Bernadette
authors.initials: MDB
authors.lastname: Fouché
authors.forename: Elsie
authors.initials: E
authors.lastname: Lafosse
authors.forename: Benjamin
authors.initials: B
authors.lastname: Nygren
authors.forename: Gerardo A
authors.initials: GA
authors.lastname: Gómez
authors.forename: Georges A
authors.initials: GA
authors.lastname: Dahourou
authors.forename: W Roodly
authors.initials: WR
authors.lastname: Archer
authors.forename: Amanda B
authors.initials: AB
authors.lastname: Payne
authors.forename: W Craig
authors.initials: WC
authors.lastname: Hooper
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Gordana
authors.initials: G
authors.lastname: Derado
authors.forename: Roc
authors.initials: R
authors.lastname: Magloire
authors.forename: Peter
authors.initials: P
authors.lastname: Gerner-Smidt
authors.forename: Nicole
authors.initials: N
authors.lastname: Freeman
authors.forename: Jacques
authors.initials: J
authors.lastname: Boncy
authors.forename: Eric D
authors.initials: ED
authors.lastname: Mintz
authors.lastname: The Cholera Serosurvey Working Group
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D055815:Young Adult